Обмен кальция и витамина D при морбидном ожирении, в том числе у больных, перенесших билиопанкреатическое шунтирование

Проведено исследование метаболизма кальция и витамина D при морбидном ожирении (МО), в том числе после бариатрических вмешательств. 1-ю группу составили пациенты с ИМТ > 40 кг/м2 (n=22); 2-ю группу - пациенты, перенесшие билиопанкреатическое шунтирование (БПШ) (n=23); 3-ю (контрольную) группу - здоровые добровольцы без ожирения и избыточной массы тела (n=22). Группы различались по уровню обеспеченности витамином D (р<0,001). Повышенный уровень паратиреоидного гормона (ПТГ) определялся у 4 (18%) больных с МО, у 12 (52%) перенесших БПШ, и не был выявлен ни у одного человека в контрольной группе. Сравнение частот вторичного гиперпаратиреоза (ВГПТ) в 1-й и 2-й группах подтвердило его более высокую распространенность среди оперированных пациентов (р=0,029). Таким образом, отмечена более высокая встречаемость дефицита витамина D среди больных с МО по сравнению с контрольной группой (р=0,007). Обследование пациентов, перенесших БПШ, продемонстрировало высокую частоту ВГПТ, развивающегося в отдаленные сроки после операции.

билиопанкреатическое шунтирование, витамин D, ПТГ, вторичный гиперпаратиреоз, ожирение

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